Urinary

The nurse is planning client teaching for a client with end-stage kidney disease who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula? "One needle will be inserted into the fistula for each dialysis treatment." "The fistula can be used 5 to 7 days after the surgery for dialysis treatment." "The arm should be immobilized for 4 to 6 days." "A vein and an artery in your arm will be attached surgically."

"A vein and an artery in your arm will be attached surgically."

A 76-year-old client with ESKD has been told by the physician that it is time to consider hemodialysis until a transplant can be found. The client tells the nurse she is not sure she wants to undergo a kidney transplant. What would be an appropriate response for the nurse to make? "The decision is certainly yours to make, but be sure not to make a mistake." "Have you talked this over with your family?" "I understand your hesitancy to commit to a transplant surgery. Success is comparatively rare." "Kidney transplants in patients your age are as successful as they are in younger patients."

"Kidney transplants in patients your age are as successful as they are in younger patients."

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report? "When did you last urinate?" "How much fluid are you drinking?" "Do you get up at night to urinate?" "Have you had a fever and chills?"

"When did you last urinate?"

The nurse is caring for a 37-year-old female client with potential interstitial cystitis. Which question, asked by the nurse, is helpful in suggesting the disease? "When was your last menstrual period?" "Have you noted any unusual vaginal drainage?" "Have you experienced hematuria with cramping?" "Do you drink alcoholic beverages on a frequent basis?"

"When was your last menstrual period?"

A client who is diagnosed with calcium oxalate stones is instructed to limit calcium intake. The client is instructed to consume ______ mg of calcium per day, or less, as part of dietary treatment. 1000 1500 2000 1250

1000

The client tells the nurse of the feeling of always needing to void. The nurse instructs on normal urine elimination. At which amount of urine accumulation in the bladder is the nerve reflex triggered to signal the need to void? 500 mL 150 mL 300 mL 750 mL

150 mL

The nurse is caring for a client recently diagnosed with renal calculi. The nurse should instruct the client to increase fluid intake to a level where the client produces at least how much urine each day? 2,750 mL 1,250 mL 3,500 mL 2,000 mL

2000 mL

A client with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The client weighs 60 kg. The nurse is monitoring the client's urine output hourly and notifies the health care provider when the hourly output is less than what? 125 mL 100 mL 50 mL 30 mL

30 mL

The critical care nurse is monitoring the client's urine output and drains following renal surgery. What should the nurse promptly report to the primary provider? Increased urine output Absence of drain output Increased pain on movement Blood-tinged serosanguineous drain output

Absence of drain output

A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure? 6 hours after the urine is discarded With the first specimen voided after 8:00 am At 8:00 am, with or without a specimen After discarding the 8:00 am specimen

After discarding the 8:00 am specimen

The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence? Anticholinergic Cholinergic Diuretics Anticonvulsant

Anticholinergic

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? Exercises to promote sphincter control Irrigating the urinary diversion Intermittent catheterizations Application of an ostomy pouch

Application of an ostomy pouch

The nurse is assessing a client admitted with renal stones. During the admission assessment, what parameters should the nurse address? Select all that apply. Family history of renal stones Surgical history Vaccination history Dietary history Medication history

Dietary history Family history of renal stones Medication history

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection? Drink coffee or tea to increase diuresis. Drink liberal amount of fluids. Use tub baths as opposed to showers. Void every 4 to 6 hours.

Drink liberal amount of fluids.

A client has a full bladder. Which sound would the nurse expect to hear on percussion? Resonance Dullness Tympany Flatness

Dullness

The nurse is instructing a 3-year-old's mother regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group? Hematuria Dysuria Anuria Enuresis

Enuresis

What is a characteristic of the intrarenal category of acute kidney injury (AKI)? High specific gravity Decreased urine sodium Decreased creatinine Increased BUN

Increased BUN

The nurse is caring for a client who has undergone creation of a urinary diversion. Forty-eight hours postoperatively, the nurse's assessment reveals that the stoma is a dark purplish color. What is the nurse's most appropriate response? Inform the primary provider that the vascular supply may be compromised. Assess the client for further signs and symptoms of infection. Document the presence of a healthy stoma. Liaise with the wound-ostomy-continence (WOC) nurse because the ostomy appliance around the stoma may be too loose.

Inform the primary provider that the vascular supply may be compromised.

The office nurse is providing information to a client who has experienced recurrent renal calculi. Which of the following jobs would place a client at greatest risk for calculi formation? Rumba instructor Over-the-road truck driver Nursing instructor Mining engineer

Over-the-road truck driver

Which of the following is the most common symptom of bladder cancer? Back pain Pelvic pain Altered voiding Painless gross hematuria

Painless gross hematuria

A client being treated in the hospital has been experiencing occasional urinary retention. What is the best nursing action? Provide privacy for the client. Have the client lie in a supine position. Apply a cold compress to the perineum. Use a slipper bedpan.

Provide privacy for the client.

A client is scheduled for a diagnostic MRI of the lower urinary system. What preprocedure education should the nurse include? The need to be NPO for 12 hours prior to the test The need for conscious sedation prior to the test The need to limit fluid intake to 1 liter in the 24 hours before the test Relaxation techniques to apply during the test

Relaxation techniques to apply during the test

A client with chronic kidney disease is completing an exchange during peritoneal dialysis. The nurse observes that the peritoneal fluid is draining slowly and that the client's abdomen is increasing in girth. What is the nurse's most appropriate action? Aspirate from the catheter using a 60-mL syringe. Advance the catheter 2 to 4 cm further into the peritoneal cavity. Reposition the client to facilitate drainage. Infuse 50 mL of additional dialysate.

Reposition the client to facilitate drainage.

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? Risk for infection Impaired urinary elimination Toileting self-care deficit Activity intolerance

Risk for infection

A child is brought into the clinic with symptoms of edema and dark brown rusty urine. Which nursing assessment finding would best assist in determining the cause of this problem? Elevation of blood pressure Sore throat 2 weeks ago Protein elevation in the urine Red blood cells in the urine

Sore throat 2 weeks ago

Following a nephrectomy, which assessment finding is most important in determining nursing care for the client? Urine output of 35 to 40 mL/hour Blood tinged drainage in Jackson-Pratt drainage tube SpO2 at 90% with fine crackles in the lung bases Pain of 3 out of 10, 1 hour after analgesic administration

SpO2 at 90% with fine crackles in the lung bases

Which of the following nursing actions is most important in caring for the client following lithotripsy? Administer allopurinol (Zyloprim). Notify the physician of hematuria. Strain the urine carefully for stone fragments. Monitor the continuous bladder irrigation.

Strain the urine carefully for stone fragments.

A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection? Polyuria Hypotension Weight loss Tenderness over transplant site

Tenderness over transplant site

When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information? The client loops the drainage tubing below its point of entry into the drainage bag. The client keeps the drainage bag below the bladder at all times. The client clamps the catheter drainage tubing while visiting with the family. The client sets the drainage bag on the floor while sitting down.

The client keeps the drainage bag below the bladder at all times.

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? Serum sodium level of 135 mEq/L Urine output of 20 ml/hour Temperature of 99.2° F (37.3° C) Serum potassium level of 4.9 mEq/L

Urine output of 20 ml/hour

The care team is considering the use of dialysis in a client whose renal function is progressively declining. Renal replacement therapy is indicated in which of the following situations? When the client's creatinine level drops below 1.2 mg/dL (110 mmol/L) When about 80% of the nephrons are no longer functioning When approximately 40% of nephrons are not functioning When the client's blood urea nitrogen (BUN) is above 15 mg/dL

When about 80% of the nephrons are no longer functioning

A client is having a blood urea nitrogen (BUN) test. BUN level is: decreased in renal disease and urinary obstruction. unchanged in renal disease. increased in renal disease and urinary obstruction. decreased in nephrotic syndrome.

increased in renal disease and urinary obstruction.

A client has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What contributes to the likelihood of developing urinary tract or bladder infections? Select all that apply. frequent catheter hygiene indwelling catheter decreased fluid intake increased ingestion of Vitamin C

indwelling catheter decreased fluid intake

A change that occurs during chronic glomerulonephritis is termed anemia. metabolic alkalosis. hypophosphatemia. hypokalemia.

anemia

The nurse needs to assess the fluid volume status of a client with chronic glomerulonephritis. To accurately assess the client's fluid volume status, the nurse should weigh the client daily: at the same time, using a different scale every time, with similar clothing. at the same time, on the same scale, with similar clothing. at the same time, on the same scale, with only minimal clothing. once in the morning, on the same scale, with similar clothing.

at the same time, on the same scale, with similar clothing.

Ron Davidson, a 45-year-old editor, is a client on the rehab unit where you practice nursing. Ron was involved in an MVA which left him with paraplegia and he is working toward living at home with his wife. He is currently developing an individualized CIC schedule, as he prefers to not wear a leg bag. What is the maximum amount of urine he should allow to collect before catheterization? 350 mL 500mL 600mL 100mL

350 mL

Susan Hopkins, a 32-year-old administrative assistant, is being seen by a physician with the urology practice where you practice nursing. She has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What can Mrs. Hopkins consume to decrease the likelihood of bladder infection? Prune juice Increased protein Red meat Cranberry juice

Cranberry juice

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? Diabetes insipidus Glomerulonephritis Decreased fluid intake Increased fluid intake

Decreased fluid intake

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? Reveals causative microorganisms Shows damage to the kidneys Detects calculi, cysts, or tumors If risk for chronic pyelonephritis is likely

Detects calculi, cysts, or tumors

The nurse is creating an education plan for a client who underwent a nephrectomy for the treatment of a renal tumor. What should the nurse include in the teaching plan? Inspection and care of the incision The importance of increased fluid intake Techniques for preventing metastasis Signs and symptoms of rejection

Inspection and care of the incision

A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract? Pelvic floor muscles Bladder Urethra Ureters

Ureters

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level? Administration of an insulin drip Administration of a loop diuretic Administration of sodium bicarbonate Administration of sodium polystyrene sulfonate [Kayexalate])

Administration of sodium polystyrene sulfonate [Kayexalate])

Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse? Assess the patient's back and shoulder areas for signs of internal bleeding. Enable the client to sit up and ambulate. Distract the client's attention from the pain. Provide analgesics to the client.

Assess the patient's back and shoulder areas for signs of internal bleeding.

The nurse is performing a focused genitourinary and renal assessment of a client. Where should the nurse assess for pain at the costovertebral angle? At the umbilicus and the right lower quadrant of the abdomen At the 7th rib and the xiphoid process At the lower border of the 12th rib and the spine At the suprapubic region and the umbilicus

At the lower border of the 12th rib and the spine

The nurse has implemented a bladder retraining program for an older adult client. The nurse places the client on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the client typically has approximately 50 mL of urine remaining in her bladder after voiding. What would be the nurse's best response to this finding? Place an indwelling urinary catheter. Perform a straight catheterization on this client. Avoid further interventions at this time, as this is an acceptable finding. Press on the client's bladder in an attempt to encourage complete emptying.

Avoid further interventions at this time, as this is an acceptable finding.

The nurse is reviewing the electronic health record of a client with a history of incontinence. The nurse reads that the health care provider assessed the client's deep tendon reflexes. What condition of the urinary/renal system does this assessment address? Recurrent urinary tract infections (UTIs) Renal calculi Benign prostatic hyperplasia (BPH) Bladder dysfunction

Bladder dysfunction

The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention? Secure or patch it with barrier paste. Change the wafer and pouch. Empty the pouch. Secure or patch it with tape.

Change the wafer and pouch.

A client who has suffered with recurrent renal calculi has learned that the stones were composed of calcium oxalate. In providing dietary education to this client, which food contains the highest levels of oxalate and should be limited? Bananas Chocolate Beef Herbal teas

Chocolate

A client is brought to the renal unit from the PACU status postresection of a renal tumor. Which of the following nursing actions should the nurse prioritize in the care of this client? Increasing mobility Managing dialysis Managing postoperative pain Increasing oral intake

Managing postoperative pain

When teaching a client about a diagnostic procedure, which teaching philosophy provides the best manner to present the information to the client? Begin with the information most difficult to understand. Stand beside the client and direct all information in the client's direction. Include humorous pictures to lighten the mood. Move from general details of the procedure to specifics.

Move from general details of the procedure to specifics.

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. Specific gravity compares the density of urine to the density of distilled water. Which is an example of how urine concentration is affected? On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity. On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity. When the kidneys are diseased, the ability to concentrate urine may be impaired, and the specific gravity may vary widely. A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity.

On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom? Frequency Fever Urinary retention Painless hematuria

Painless hematuria

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? Hypoventilation Increased alertness Unusually smooth skin Pruritus

Pruritis

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? Bactrim Septra Levaquin Pyridium

Pyridium

A 32-year-old client has been admitted to the renal unit with acute pyelonephritis. She is undergoing parenteral antibiotic treatment. As her nurse, what would be a significant aspect of your discharge education? Anti-inflammatory incompatibilities Recurring infection prevention Needed dietary changes No options are correct

Recurring infection prevention

Which of the following is an age-related change associated with the renal system? Increased bladder capacity Renal arteries thicken Kidney weight increases Blood flow increase

Renal arteries thicken

A 32-year-old flight attendant is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography and you are in the midst of completing client education about the procedure. The client asks what the angiography will reveal. What is your response, as her nurse? Renal circulation Kidney structure Kidney function Urine production

Renal circulation

The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure? Vasopressin Cortisol Renin Albumin

Renin

A nurse is teaching a client how to do Kegel exercises. Place in order from first to last the correct steps in performing these exercises. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 Draw in perivaginal muscles and anal sphincter as when controlling voiding or defecating. 2 Sit or stand with legs slightly apart. 3 Relax contraction for at least 10 seconds. 4 Hold position of contraction for 5 seconds (count or time with a watch). 5 Repeat exercises 5 to 6 times, increasing slowly to 25 times.

Sit or stand with legs slightly apart. Draw in perivaginal muscles and anal sphincter as when controlling voiding or defecating. Hold position of contraction for 5 seconds (count or time with a watch). Relax contraction for at least 10 seconds. Repeat exercises 5 to 6 times, increasing slowly to 25 times.

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: Protein 15 mg/dL Creatinine 0.7 mg/dL Specific gravity 1.035 Bright yellow urine

Specific gravity 1.035

The nurse is caring for a client who is following a treatment plan to decrease urinary tract infections. Which of the following indicates the need to change the treatment plan? The client has improved personal hygiene methods. The client has history of repeated antibiotic therapy. The client has diluted urine. The client exhibits continued symptoms.

The client exhibits continued symptoms.

The nurse is caring for a client with a history of systemic lupus erythematosus who has been recently diagnosed with end-stage kidney disease (ESKD). The client has an elevated phosphorus level and has been prescribed calcium acetate to bind the phosphorus. The nurse should teach the client to take the prescribed medication at what time? First thing in the morning Daily at bedtime With each meal Only when needed

With each meal

The nurse is administering calcium acetate (PhosLo) to a patient with end-stage renal disease. When is the best time for the nurse to administer this medication? 2 hours after meals At bedtime with 8 ounces of fluid With food 2 hours before meals

With food

A client develops acute renal failure (ARF) after receiving IV therapy with a nephrotoxic antibiotic. Because the client's 24-hour urine output totals 240 mL, the nurse suspects that the client is at risk for: cardiac arrhythmia. pruritus. dehydration. paresthesia.

cardiac arrhythmia.

A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should: apply pressure to the puncture site for 30 minutes. keep the client's knee on the affected side bent for 6 hours. remove the dressing on the puncture site after vital signs stabilize. check the client's pedal pulses frequently.

check the client's pedal pulses frequently.

The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration? phenytoin infection metronidazole phenazopyridine hydrochloride

phenazopyridine hydrochloride

A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be? A GFR of 120 mL/min/1.73 m2 A GFR of 85 mL/min/1.73 m2 A GFR of 30-59 mL/min/1.73 m2 A GFR of 90 mL/min/1.73 m2

A GFR of 30-59 mL/min/1.73 m2

A client has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the client about what topic? Typical diet Allergy status Psychosocial stressors Current medication use

Current medication use

A client is diagnosed with polycystic kidney disease and requires teaching on the management of the disorder. Which statement made by the client indicates a need for further teaching? "The cysts can get quite large in size." "If renal failure develops, I may need to consider dialysis." "As long as I have one normal kidney, I should be fine." "I inherited this disorder from one of my parents."

"As long as I have one normal kidney, I should be fine."

A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse? "The doctor may decide to delay the use of immunosuppressant drugs." "Even a perfect match does not guarantee organ success." "Let's wait until after the surgery to discuss your treatment plan." "Immunosuppressive drugs guarantee organ success."

"Even a perfect match does not guarantee organ success."

A 45-year-old man with diabetic nephropathy has end-stage renal disease and is starting dialysis. What should the nurse teach the client about hemodialysis? "Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine again." "Hemodialysis is a program that will require you to commit to daily treatment." "This will require you to have surgery and a catheter will need to be inserted into your abdomen." "Hemodialysis is a treatment option that is usually required three times a week."

"Hemodialysis is a treatment option that is usually required three times a week."

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? "A catheter will drain urine directly from my kidney." "My urine will be eliminated with my feces." "My urine will be eliminated through a stoma." "I will not need to worry about being incontinent of urine."

"My urine will be eliminated through a stoma."

A nurse is aware of the high incidence and prevalence of fluid volume deficit among older adults. What related health education should the nurse provide to an older adult? "If possible, try to drink at least 4 liters of fluid daily." "Remember to drink frequently, even if you don't feel thirsty." "Ensure that you avoid replacing water with other beverages." "Make sure you eat plenty of salt in order to stimulate thirst."

"Remember to drink frequently, even if you don't feel thirsty."

An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse? "This type of dialysis will provide more independence." "The risk of peritonitis is greater with this type of dialysis." "Peritoneal dialysis does not work well for every client." "Peritoneal dialysis will require more work for you."

"This type of dialysis will provide more independence."

A nurse on a busy medical unit provides care for many clients who require indwelling urinary catheters at some point during their hospital care. The nurse should recognize a heightened risk of injury associated with indwelling catheter use in which client? A client who has Alzheimer disease and who is acutely agitated A client who is on bed rest following a recent episode of venous thromboembolism A client who has decreased mobility following a transmetatarsal amputation A client whose diagnosis of chronic kidney disease requires a fluid restriction

A client who has Alzheimer disease and who is acutely agitated

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest? A low-sodium diet A diet high in fruits and vegetables A diet high in calcium A low-purine diet

A low-purine diet

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? Restricting fluid intake to reduce the need to void Assessing present voiding patterns Encouraging the client to increase the time between voidings Establishing a predetermined fluid intake pattern for the client

Assessing present voiding patterns

When assessing a client with chronic glomerulonephritis, the nurse notes that the client has generalized edema. The nurse documents this as which of the following? Anasarca Hydronephrosis Uremic frost Periorbital edema

Anasarca

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? Intermittent catheterizations Application of an ostomy pouch Exercises to promote sphincter control Irrigating the urinary diversion

Application of an ostomy pouch

The nurse is caring for a client who has returned to the postsurgical suite after postanesthetic recovery from a nephrectomy. The nurse's most recent hourly assessment reveals a significant drop in level of consciousness and BP as well as scant urine output over the past hour. What is the nurse's best response? Assess the client for signs of bleeding and inform the primary provider. Palpate the client's flanks for pain and inform the primary provider. Reposition the client and reassess vital signs. Monitor the client's vital signs every 15 minutes for the next hour.

Assess the client for signs of bleeding and inform the primary provider.

A client undergoes dialysis as a part of treatment for kidney failure, and is administered heparin during dialysis to achieve therapeutic levels. Which step should the nurse take to allow heparin to be metabolized and excreted in the client? Use dialysate solutions after 2 hours. Provide periods of rest throughout the day and uninterrupted sleep at night. Puncture the same site used previously. Avoid administering injections for 2 to 4 hours after heparin administration.

Avoid administering injections for 2 to 4 hours after heparin administration.

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis? Bacteremia Azotemia Hematuria Proteinuria

Azotemia

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education? Uses moisturizing creams Pats skin dry after bathing Brief, hot daily showers Keeps nails trimmed short

Brief, hot daily showers

Which information is important when teaching a client how to perform self-catheterization? Peroxide is recommended for cleaning the urinary catheter. The nurse uses nonsterile technique in the hospital setting. The catheter is rinsed with sterile normal saline after being soaked in a cleaning solution. Catheterization should occur every 4 to 6 hours and before bedtime.

Catheterization should occur every 4 to 6 hours and before bedtime.

As a result of trauma, a client has developed urinary incontinence and is beginning bladder training to regain control over urine elimination. What is the initial step to begin bladder training for a client with an indwelling catheter? Remove the catheter. Clamp the catheter. Perform catheter care. Unclamp the catheter.

Clamp the catheter.

The nurse at the diabetes clinic is instructing a client who is struggling with compliance to the diabetic diet. When discussing disease progression, which manifestation of the disease process on the urinary system is most notable? Clients have urinary frequency. Clients develop a neurogenic bladder. Clients have frequent urinary tract infections. Clients have chronic renal failure.

Clients have chronic renal failure.

The nurse caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period? Assess renal blood work. Complete a pulse assessment of the legs and feet. Assess cognitive status. Encourage voiding following the procedure.

Complete a pulse assessment of the legs and feet.

The nurse discusses a care plan with a male patient who is to be discharged after a biopsy. He is instructed to maintain limited activity and report signs of systemic infection, urinary tract infection, or bleeding. Which additional instructions should the nurse include in the care plan? No physical activity. Complete the prophylactic antibiotic therapy. Assess the dressing frequently. Decrease the intake of iodine or seafood.

Complete the prophylactic antibiotic therapy.

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish? Cystoscopy Computed tomography with contrast Bladder ultrasonography Radiography

Computed tomography with contrast

Which of the following urine characteristics would the nurse anticipate when caring for a client whose lab work reveals a high urine specific gravity related to dehydration? Dark amber urine Turbid urine Red urine Clear or light yellow urine

Dark amber urine

Diagnostic testing of an adult client reveals renal glycosuria. The nurse should recognize the need for the client to be assessed for what health problem? Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Renal carcinoma Diabetes insipidus Diabetes mellitus

Diabetes mellitus

A client with a history of incontinence will undergo urodynamic testing in the health care provider's office. Because voiding in the presence of others can cause situational anxiety, the nurse should perform what action? Administer diuretics as prescribed. Push fluids for several hours prior to the test. Help the client to relax before and during the test. Discuss possible test results as the client voids.

Help the client to relax before and during the test.

The nurse is caring for a client with cystitis. Which adjunct therapy is the nurse most correct to suggest to keep bacteria from adhering to the wall of the bladder? Douching with a vinegar solution Wiping from the urethra to rectum Flushing the system with water Drinking cranberry juice

Drinking cranberry juice

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to: Strain all urine for 48 hours. Apply moist heat to the flank area. Monitor for hematuria. Encourage high fluid intake.

Encourage high fluid intake.

A client has undergone the creation of an Indiana pouch for the treatment of bladder cancer. The nurse identified the nursing diagnosis of "disturbed body image." How can the nurse best address the effects of this urinary diversion on the client's body image? Provide the client with detailed written materials about the diversion at the time of discharge. Allow the client to initiate the process of providing care for the diversion. Encourage the client to speak openly and frankly about the diversion. Emphasize that the diversion is an integral part of successful cancer treatment.

Encourage the client to speak openly and frankly about the diversion.

A client admitted with nephrotic syndrome is being cared for on the medical unit. When writing this client's care plan, based on the major clinical manifestation of nephrotic syndrome, what nursing diagnosis should the nurse include? Risk for injury related to altered thought processes Constipation related to immobility Excess fluid volume related to generalized edema Hyperthermia related to the inflammatory process

Excess fluid volume related to generalized edema

Which of the following causes should the nurse suspect in a client diagnosed with intrarenal failure? Glomerulonephritis Dysrhythmia Ureteral calculus Hypovolemia

Glomerulonephritis

The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develops oliguria, and laboratory results indicate azotemia. The client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most appropriate for the client? Continuous arteriovenous hemofiltration (CAVH) Peritoneal dialysis Continuous venovenous hemofiltration (CVVH) Hemodialysis

Hemodialysis

A client with a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test of renal function relating to erythropoiesis. When assessing the oxygen transport ability of the blood, the nurse should prioritize the review of what blood value? Hemoglobin Erythrocyte sedimentation rate (ESR) Serum creatinine Hematocrit

Hemoglobin

Regulation of electrolyte balance is a management goal for patients suffering from renal disease. Which of the following lab results is considered the most life-threatening effect of renal failure? Hypocalcemia Hyperkalemia Hyperphosphatemia Hypernatremia

Hyperkalemia

The nurse is caring for a client in acute kidney injury. Which of the following complications would most clearly warrant the administration of polystyrene sulfonate? Hypomagnesemia Hypernatremia Hyperkalemia Hypercalcemia

Hyperkalemia

A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures? Elevated serum creatinine Elevated urea and nitrogen Hyperphosphatemia Hyperkalemia

Hyperphosphatemia

A client has a family history of polycystic kidney disease. As the nurse gathers information and completes an assessment related to a polycystic kidney diagnosis, which findings would the nurse expect to find? Select all that apply. No renal stones Normal urinalysis Polyuria Hypertension Pain from retroperitoneal bleeding

Hypertension Pain from retroperitoneal bleeding Polyuria

The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which item should the nurse include? Perform straight catheterization every 4 hours Implement a 2- to 3-hour voiding schedule Avoid drinking fluids for 6 hours Encourage voiding immediately after catheter removal

Implement a 2- to 3-hour voiding schedule

A nurse is working with a client who will undergo invasive urologic testing. The nurse has informed the client that slight hematuria may occur after the testing is complete. The nurse should recommend what action to help resolve hematuria? Use of an over-the-counter (OTC) diuretic after the test Activity limitation for the first 12 hours after the test Gentle massage of the lower abdomen Increased fluid intake following the test

Increased fluid intake following the test

A 17-year-old high school student is returning to the medical-surgical unit following an appendectomy. She reports the need to urinate and cannot do so. What type of procedure will you perform to resolve her difficulty? Intermittent catheterization under sterile conditions Indwelling catheterization under clean conditions Indwelling catheterization under sterile conditions Intermittent catheterization under clean conditions

Intermittent catheterization under sterile conditions

The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following? Neurogenic bladder Fistula Chronic renal failure Kidney stones

Kidney stones

The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would be the daily urine output? 1.0 L 1.5 L Less than 400 mL Less than 50 mL

Less than 400 mL

The nurse is caring for a client after kidney surgery. When assessing for bleeding, what assessment parameter should the nurse evaluate? Pain intensity Level of consciousness Oral intake Radiation of pain

Level of consciousness

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following? Elevated calcium levels Structural defects in the kidneys Abnormalities in urine Location of discomfort

Location of discomfort

A client undergoes surgery for removing a malignant tumor, followed by a urinary diversion procedure. Which of the following postoperative procedures should the nurse perform? Show photographs and drawings of the placement of the stoma Maintain skin and stomal integrity. Suggest a visit to a local ostomy group. Determine the client's ability to manage stoma care.

Maintain skin and stomal integrity.

The nurse is caring for a client who underwent percutaneous lithotripsy earlier in the day. What instruction should the nurse give the client? Limit oral fluid intake for 1 to 2 days. Report any pink-tinged urine within 24 hours after the procedure. Notify the health care provider about cloudy or foul-smelling urine. Report the presence of fine, sand like particles through the nephrostomy tube.

Notify the health care provider about cloudy or foul-smelling urine.

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? Perform meticulous perineal care daily with soap and water Use sterile technique to disconnect the catheter from the tubing to obtain urine specimens Place the catheter bag on the client's abdomen when moving the client Use clean technique during insertion

Perform meticulous perineal care daily with soap and water

Retention of which electrolyte is the most life-threatening effect of renal failure? Phosphorous Sodium Potassium Calcium

Potassium

A 44-year-old client is in the hospital unit where you practice nursing. From the results of a series of diagnostic tests, she has been diagnosed with acute glomerulonephritis. What would you expect to find as a result of this condition? Pyuria Proteinuria No option is correct Polyuria

Proteinuria

The nurse is working with a client whose health history includes occasional episodes of urinary retention. What assessment finding would suggest that the client is currently retaining urine? The client claims to void large amounts of urine two to three times daily. The client's suprapubic region is dull on percussion. The client is uncharacteristically drowsy. The client takes a beta adrenergic blocker for the treatment of hypertension.

The client's suprapubic region is dull on percussion.

The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness? The costovertebral angle The upper abdominal quadrants on the left and right side Above the symphysis pubis Around the umbilicus

The costovertebral angle

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure? Kidney function will improve with transplant. Acute renal failure tends to turn to end-stage failure. Once on dialysis, the need will be permanent. The kidneys can improve over a period of months.

The kidneys can improve over a period of months.

A female client has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the client, the nurse should address what topic? The need to expect a heavy menstrual period following the course of antibiotics The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy The need to undergo a series of three urine cultures after the antibiotics have been completed The risk of developing antibiotic resistance after the course of antibiotics

The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy

The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated? The specific gravity will equal to one The specific gravity will be low The specific gravity will be inversely proportional The specific gravity will be high.

The specific gravity will be high.

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence? Functional Stress Urge Overflow

Urge

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? Ureteral stricture Renal cell carcinoma Urinary calculi Acute glomerulonephritis

Urinary calculi

A nurse's colleague has applied an incontinence pad to an older adult client who has experienced occasional episodes of functional incontinence. What principle should guide the nurse's management of urinary incontinence in older adults? Diuretics should be promptly discontinued when an older adult experiences incontinence. Urinary catheterization is a first-line treatment for incontinence in older adults with incontinence. Restricting fluid intake is recommended for older adults experiencing incontinence. Urinary incontinence is not considered a normal consequence of aging.

Urinary incontinence is not considered a normal consequence of aging.

A nurse is preparing a client diagnosed with benign prostatic hyperplasia (BPH) for a lower urinary tract cystoscopic examination. The nurse should caution the client about what common temporary complication of this procedure? Bladder perforation Nausea Hemorrhage Urinary retention

Urinary retention

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? Serum creatinine level of 1.2 mg/dl Blood urea nitrogen (BUN) level of 22 mg/dl Temperature of 100.2° F (37.8° C) Urine output of 250 ml/24 hours

Urine output of 250 ml/24 hours

A nurse is caring for a female client whose urinary retention has not responded to conservative treatment. When educating this client about self-catheterization, the nurse should encourage what practice? Inserting the catheter 1 to 2 inches (2.5 to 5 cm) into the urethra Using clean technique at home to catheterize Assuming a supine position for self-catheterization Self-catheterizing every 2 hours at home

Using clean technique at home to catheterize

A client has been asked to provide a clean-catch midstream urine specimen. It is important that the instructions are clear and that things are done in the proper order. Select the proper sequence of events for obtaining a specimen from a client. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands. Open the antiseptic towelette package and cleanse the urethral area. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Open the antiseptic towelette package and cleanse the urethral area. Carefully replace the lid, dry the container if necessary, and wash hands. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Open the antiseptic towelette package and cleanse the urethral area. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Begin voiding into the toilet. Open the antiseptic towelette package and cleanse the urethral area. Void 30 to 50 mL of the midstream urine into the collection

Wash hands and remove the lid from the specimen container without touching the inside of the lid. Open the antiseptic towelette package and cleanse the urethral area. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands.

A patient taking an alpha-adrenergic medication for the treatment of hypertension is having a problem with incontinence. What does the nurse tell the patient? The medication has caused permanent damage to the bladder sphincter and will require surgical correction. The patient will require a medication regimen to decrease the overactivity of the bladder. Relaxation of the supporting ligaments has occurred and the patient will need to perform pelvic floor exercises to strengthen them. When the medication is discontinued or changed, the incontinence will resolve.

When the medication is discontinued or changed, the incontinence will resolve.

An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should: confirm which beverages the client normally consumes. assess the client's usual intake of sodium. palpate the client's bladder before and after voiding. confirm all of the medications and supplements normally taken.

confirm all of the medications and supplements normally taken.

A client is being treated for a malignant bladder tumor. What would be included in treatment of a small tumor? Select all that apply. resection and fulguration topical application of an antineoplastic drug urinary diversion cystectomy

resection and fulguration topical application of an antineoplastic drug